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Gemelli-obturator complex in the deep gluteal space: an anatomic and dynamic study
Ramon Balius1,2, Antonio Susín3, Carles Morros4
1Consell Català de l'Esport, Generalitat de Catalunya, Barcelona, Spain. ramonbaliusmatas@gmail.com.
Skeletal Radiology
|December 9, 2017
Summary
The sciatic nerve moves dynamically with hip rotation, tethered by connective tissue to the gemelli-obturator internus complex. This nerve behavior during hip rotation may explain obturator internus gemellus syndrome.
Area of Science:
- Anatomy
- Biomechanics
- Musculoskeletal Imaging
Background:
- The sciatic nerve's behavior in the subgluteal space during hip movement is not fully understood.
- The gemelli-obturator internus complex plays a role in hip stability and rotation.
Purpose of the Study:
- To investigate the dynamic behavior of the sciatic nerve during hip rotation within the subgluteal space.
- To explore the anatomical relationship between the sciatic nerve and the gemelli-obturator internus complex.
Main Methods:
- Sonographic examination using a high-resolution ultrasound machine (5.0-14 MHz).
- Studies conducted on six fresh cadavers and 31 healthy volunteers.
- Evaluated nerve behavior during passive internal and external hip rotation in fixed pelvic positions.
Main Results:
- Anatomical analysis revealed connective tissue attaching the sciatic nerve to the gemelli-obturator system.
- Sciatic nerve curvature significantly increased during rotation compared to resting positions.
- Internal hip rotation caused the sciatic nerve to become tethered and curved due to obturator internus tendon contraction; external rotation led to nerve relaxation.
Conclusions:
- The sciatic nerve has a close anatomical relationship with the gemelli-obturator internus complex.
- This relationship leads to reproducible dynamic sciatic nerve behavior during passive hip rotation.
- The findings may elucidate the pathological mechanisms underlying obturator internus gemellus syndrome.
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